A histomorphometric meta-analysis of sinus elevation with various grafting materials

Several grafting materials have been used in sinus augmentation procedures including autogenous bone, demineralized freeze-dried bone (DFDBA), hydroxyapatite, β-tricalcium phosphate (β-TCP), anorganic deproteinized bovine bone and combination of these and others. Up to now a subject of controversy in maxillofacial surgery and dentistry is, what is the most appropriate graft material for sinus floor augmentation

Bone regeneration in surgically created defects filled with autogenous bone: an epifluorescence microscopy analysis in rats

Although the search for the ideal bone substitute has been the focus of a large number of studies, autogenous bone is still the gold standard for the filling of defects caused by pathologies and traumas, and mainly, for alveolar ridge reconstruction, allowing the titanium implants installation. OBJECTIVES: The aim of this study was to evaluate the dynamics of autogenous bone graft incorporation process to surgically created defects in rat calvaria, using epifluorescence microscopy. MATERIAL AND METHODS: Five adult male rats weighing 200-300 g were used. The animals received two 5-mm-diameter bone defects bilaterally in each parietal bone with a trephine bur under general anesthesia. Two groups of defects were formed: a control group (n=5), in which the defects were filled with blood clot, and a graft group (n=5), in which the defects were filled with autogenous bone block, removed from the contralateral defect. The fluorochromes calcein and alizarin were applied at the 7th and 30th postoperative days, respectively. The animals were killed at 35 days. RESULTS: The mineralization process was more intense in the graft group (32.09%) and occurred mainly between 7 and 30 days, the period labeled by calcein (24.66%). CONCLUSIONS: The fluorochromes showed to be appropriate to label mineralization areas. The interfacial areas between fluorochrome labels are important sources of information about the bone regeneration dynamics

Microscopic and radiographic analysis of the effect of particle size of demineralized bovine cancellous bone matrix on the repair of bone defects in femurs of rabbits Análise microscópica e radiográfica do efeito do tamanho das partículas de matriz de osso medular bovino desmineralizado na reparação de defeito ósseo em fêmures de coelhos

The bone tissue has a great regenerative potential, with ability to completely restore its structure and original functions. In some situations, though, bone defects cannot be self-repaired, thus requiring the use of grafts for a correct treatment and good prognosis. This work aimed at microscopically analyzing the effect of the particle size of demineralized bovine cancellous bone matrix in micro and macrogranular forms on the repair of bone defects in femurs of rabbits, with blood clot used as control. At 1, 3 and 6 months after implantation of the materials, the animals were killed and the anatomic specimens were removed. A foreign body-type granulomatous reaction containing macrophages and multinucleated giant cells in contact with the implanted particles was observed. These results suggest a failure in demineralization and/or interruption of the antigenic potential during production of the biomaterial. It is concluded that the size of the particles did not influence the evolution of the repair process of bone defects, acting only as bone-filler substances, and that the material implanted should be improved by quality control during production, since it may represent a good alternative for bone graft.<br>O tecido ósseo possui grande potencial regenerativo com capacidade para restaurar completamente sua estrutura e função originais. Há situações em que os defeitos ósseos não conseguem por si só obter o reparo, casos em que se fazem necessários o uso de enxertos, para um correto tratamento e bom prognóstico. Este experimento teve o propósito de analisar microscopicamente o efeito do tamanho das partículas de matriz de osso medular bovino desmineralizado, nas formas micro e macrogranular, na reparação de defeito ósseo em fêmures de coelhos, tendo como controle o coágulo sanguíneo. Após 1,3 e 6 meses da implantação dos materiais, os animais foram mortos e as peças anatômicas removidas. Uma reação granulomatosa tipo corpo estranho, envolvendo as partículas implantadas, foi observada. Estes resultados sugerem falhas na desmineralização e/ou na retirada de potenciais antigênicos durante a produção do biomaterial. Podemos concluir que o tamanho das partículas não influenciou na evolução do processo reparativo dos defeitos ósseos, atuando apenas como substâncias osteopreenchedoras e que o material implantado deverá sofrer um aprimoramento no controle de qualidade na linha de produção, uma vez que poderá representar uma boa alternativa para enxertos ósseos

Histologic and histomorphometric results of three bone graft substitutes after sinus augmentation in humans.

The aim of this study was to compare the histological behavior of three bone graft materials placed in human. The comparison was made among Bio-Oss\uae (BO), Engipore\uae (EP), and PepGen P-15\uae (P-15). Five biopsies for each group of biomaterial, retrieved 6 months after sinus lift augmentation, were analyzed. The investigation was carried out using light microscope (LM), scanning electron microscope (SEM) with an energy dispersive spectrometer (EDS), and circularly polarized light microscope (CPLM). Under LM, the amount of newly formed bone was significantly higher in BO than P-15 (P < .05), while the amount of residual graft material was significantly higher in P-15 than BO (P < .05). The extension of marrow spaces was significantly higher in EP than both BO and P-15 (P < .05). SEM-EDS analysis showed a Ca/P ratio of 1.8 for BO, 2.2 for EP, and 1.5 for P-15. Under CPLM, BO showed no significant difference for transverse (18.4 \ub1 2.7\%) and longitudinal (16.3 \ub1 1.8\%) bone collagen fibers (P = .195); EP showed a significant difference between transverse (4 \ub1 0.7\%) and longitudinal (7.6 \ub1 2.5\%) bone collagen fibers (P = .015); finally, P-15 showed no significant difference for transverse (3.8 \ub1 1.6\%) and longitudinal (4.9 \ub1 1.2\%) bone collagen fibers (P = .279). No investigated biomaterial was completely resorbed, but all the residual particles demonstrated a close bone integration to form a hybrid tissue. BO particles appeared perfectly osseointegrated in the trabecular bone. EP showed a tendency to concentrate the bone apposition into the microporosities; P-15 particles appeared bridged by newly formed bone trabeculae